Lumbar-Pelvic Instability (Poor Core Control)

Lumbo-pelvic instability is the result of inability for the supporting structures of the trunk to maintain the optimum position of the spine and pelvic girdle.

causes

Common causes for lumbo-pelvic instability include:

• Acute Low Back Injury
• Chronic Low Back Pain
• Post Abdominal or Pelvic Surgery
• Pregnancy
• Post Natal

understanding lumbar and pelvic instability

The stability of the trunk and pelvis is provided by a combination of passive, active and neural control. Instability arises when one or more of these components is not functioning appropriately and support of good skeletal alignment is not provided.

passive control of the trunk

This is provided by the physical structures such as the vertebrae of the spine, the bones of the pelvic girdle, the ligaments between the bones, and the tendons and fascia

active control of the trunk

Active control is provided by the postural and movement muscles around the spine and pelvis. These muscles produce core stability by working to support the bones (postural muscles) and provide appropriate movement (movement muscles)

neural control of the trunk

Neural control of the trunk relies on sensory feedback from the joint receptors, ligament receptors and muscle receptors, and these work simultaneously to stabilise the spine in all positions. The neural control of the spine can be adversely impacted upon by injury, surgery, or pregnancy.

assessment

Pelivc instability is assessed by a history and physical examination. This can involve assessing:

• Position of the spine and pelvis in static positions
• Position of sine and pelvis through movment
• Palpation of the joint movement in the pelvis and spinal coloumn

real time ultrasound assessment

Assessment using Real Time Ultrasound tests the specific action of the muscles which should normally provide core stability around the trunk and pelvis. This helps us to understand how the active and nueral control mechanisms are working. This may also be used to provide feedback to the client to help improve the function of these muscles.

For more information check out our services page on “Real Time Ulatrasound Assessemnt”

management

Management of lumbopelvic instability can occur through anumber of stages

correct alignment of skeletal structure

Pain from instability occurs due to the poor alignment of the pelvic and spinal joints. This can be corrected by joint mobilisation, muscle energy tehcnqies, soft tissue techniques, stretching, dry needling.

improve the function of core stabilising muscles

Initially this is done using feedback from a Real Time Ultrasound machine where the exact function of the core stabilising muscles can be detected. Here we are working on developing Active and Nerual control via the core muscles.

Once these muscles are correctly activiated the client is able to progress to a Pilates based strengthening program.

Pilates strengthening to enhance functional core stability

Pilates based rehabilitation provides an opportunity to restore the structure and function of the core stability muscles, and provide greater efficiency when performing exercises involving the upper or lower body. Pilates based exercises are individually tailored to your specific requirements, such as return to sport, or return to work.

For more information check out our services page on “Pilates Equipment Studio”